High Fiber over Low FatPublished 2.29.2016
Let's talk about fiber. I've mentioned the Carb-Sane Asylum here occasionally, though I don't link to it as often as I should. I've read there for years now, and in the past three or four I've occasionally participated in the comments section. Most comment sections are a waste of time to read through, typically generating more heat than light, which is why I have never had a comment section and never will. In a recent exchange in the comments on this post, I was asked about my diet in the context of improving the insulin sensitivity of diabetics (mostly type one diabetics (T1D) but also type 2 diabetics (T2D)) with a high carb low fat diet. I postulated that perhaps it was the very high fiber content of the diet, rather than the very low fat levels that had the good effect and was challenged about it. This piece is the result of my considering my fiber hypothesis.
Fiber was often mentioned in the Fat Summit. The presence of fiber alters the metabolization of both carbs and fats. With the exception of meat shill Teicholz, every speaker (of the ones I listened to, I didn’t listen to everyone) stressed that the problem was UNREFINED (in other words, fiberless) carbohydrates (carbs) that were the problem. Plant fats in their original form (as a whole food, be it seed, nut or avocado etc) were not the problem.
Some of the funniest exchanges were when Hyman (who I think may have a coconut oil that he will eventually hawk) asserted again and again and again that saturated fat in coconut oil was just fine got shot down by guests saying no, coconut oil is refined, eat the coconut flesh instead. Hyman claimed to have written his new book in two weeks while drinking a huge bolus of coconut fat in his coffee. The book, if you're interested, is Eat Fat, Get Thin.
The opinions on animal fat and refined oils were split in the summit, but everyone agreed that eating high fat whole plants (seeds and nuts) was not a health danger. Dean Ornish even allowed that he'd added seeds and nuts to his list of approved foods. Fiber is only found in plants, therefore if the goal is to eat a high fiber diet, then eating a lot of plants is required. A high fiber diet does not need to be vegan or vegetarian, but fiber is filling, so it likely follows that less animal products are eaten. Unless you eat a lot of dairy and/or refined oils, eating a high fiber diet makes it harder to eat a lot of fat. That's why fools eating and extreme percentage of the food as fat (I've seen claims as high as 80% fat) have to eat dairy. Because dairy is mostly saturated fat, particularly cheese and butter.
High fat plant foods make a high fiber diet more palatable. If you glance through the "Vegan-osphere," it becomes clear that many people find staying on a vegan diet to be difficult. There are many reasons for this, but one of them certainly is the ridiculously rigid rules so many vegans propose. Humans are not frugivores, it is not necessary to eat only fruit to be healthy. Nor is it necessary to limit fat intake to 10% of less. It is necessary to supplement with B12 if you are vegan, but other than that, the only requirement ought to be to not eat animals or animal products. Not only does creating ridiculous eating rules make veganism harder to follow than it needs to be, but some of these rules result in nutrient deficiencies over time (separate from B12). If the way you're eating winds up making you sick, that's not a long term option.
Fiber is the next fad?I am not alone in thinking that fiber content in the diet is what's important. In fact, with more blogs such as that one (and one could argue this piece too) showing up, fiber could be the next buzz word. If eating a high fiber diet becomes the next fad, it will be a better option than either the low carb high fat diet nonsense or the low fat high carb diet, which for too many people includes too many refined carb foods. The recommendation to eat a high fiber diet isn't new by any means. Joel Fuhrman has touted a high fiber diet for years— I think one of the PBS specials was dedicated to the benefits of eating lots of fiber.
Fuhrman has honed his niche over the years. Eat to Live was a diet book that espoused a very low fat diet. In subsequent books and presentations, however, Fuhrman has said that an extremely low fat diet is not necessary for health, in fact, by avoiding high fat plant foods such as seeds and nuts, people are forgoing benefits. It's animal fats that he still looks to limit.
Fuhrman's pitch is to optimize the level of nutrients in the diet, and that means eating lots of plants. If you eat mostly unrefined plants, then you will have a good amount of fiber in your diet. In 2012, Fuhrman published a study the used his Eat to Live diet to improve the markers of T2D patients from his practice. The Eat to Live diet is very high fiber, but also very low fat. In particular, Fuhrman stresses the need to eat legumes on a daily basis. The plan is not vegan. Fuhrman doesn't actually stress the fiber content of the diet either, rather it's the nutrient density of the diet that is stressed. In fact, it's called the HND diet for high nutrient density.
Since the diet isn't vegan, it can't be said that avoiding all animal products is why it works. Although no macronutrient break down of the diet is provided, if it's the Eat to Live version that I read a few yeas ago, total fat is likely less than 20% of calories. So does it work because it's high in nutrients? Or does it work because it's high in fiber? Does it work because it's low in fat? Does it really matter? The success of the Kempner's rice diet to treat diabetes suggests that it is the fact the diet is low fat. Kempner fed people white rice (thus most of the fiber was removed), a bit of fruit, plus fruit juices and sugar (can't get more refined than that) and reversed diabetes (as well as high blood pressure and the blindness that can be a symptom of diabetes). So perhaps it is the low fat level that makes the difference.
Still, when someone asks me to describe my diet, I've taken to saying that I eat a high fiber diet. I prefer high fiber to high carbohydrate because too many people associate the word carbohydrate with sugar and refined flour products. To be clear, I eat sugar and refined carbs too, but not as the main source of my intake. Saying high fiber rather than high carb also makes it plain that I eat a lot of fruits and vegetables in a their unrefined state— because otherwise the fiber would have been removed or reduced.
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